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Friday, September 08, 2006

Consciousness in PVS - Bollocks...

The Scotsman reports in today's edition that some people in persistent vegetative state might be conscious to a certain extent and capable of responding for instance to sentences spoken to them. Steve Miles, MD, a bioethicist at the University of Minnesota comments: '1. This woman had suffered a traumatic, not ischemic, brain injury five months before the testing. 2. The MRI showed that the frontal cortex was damaged from the trauma and post accident surgery but that the cortex and white matter were essential intact.3. The PVS was diagnosed with the Royal College of Physicians 2003 guidelines. http://www.rcplondon.ac.uk/pubs/wp_vegetativestate.pdf However, those guidelines do not allow the diagnosis of post traumatic PVS until one year after the trauma because of the 20% prognosis for recovery in such persons. The clinical exam at 11.5 months showed recovery to Minimal Conscious State thus moving her outside the diagnosis of PVS as defined by the Royal College. 4. She was asked to imagine herself touring her house and playing tennis and appropriate areas of the brain showed metabolic activity. The researchers interpreted this as intentional cooperation rather than as word association responsiveness. She was not given a neutral stimulus such as “tennis” to test this difference.'